Provider Demographics
NPI:1700101425
Name:CATALINA EAR, NOSE & THROAT
Entity Type:Organization
Organization Name:CATALINA EAR, NOSE & THROAT
Other - Org Name:THE INSTITUTE FOR BALANCE & DIZZINESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACTING & CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-990-4616
Mailing Address - Street 1:5910 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3535
Mailing Address - Country:US
Mailing Address - Phone:520-498-1800
Mailing Address - Fax:520-498-1400
Practice Address - Street 1:5910 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3535
Practice Address - Country:US
Practice Address - Phone:520-498-1800
Practice Address - Fax:520-498-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1783231H00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ109628Medicare PIN